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NPI Code Detail

MEDICARE: NICHOLAS PAHL

MEDICARE: NICHOLAS PAHL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QP2000XPhysical Therapy Clinic/Center24867FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134350879
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS PAHL
Provider Business Mailing Address
First Line : 6150 N LOCKWOOD RIDGE RD
Second Line :
City : SARASOTA
State : FL
Zip : 34243-2527
Country : US
Telephone Number : 941-960-4741
Fax Number :
Provider Business Practice Location Address
First Line : 6150 N LOCKWOOD RIDGE RD
Second Line :
City : SARASOTA
State : FL
Zip : 34243-2527
Country : US
Telephone Number : 941-960-4741
Fax Number : 941-360-8525
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2009
Last Update Date : 07/21/2022

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Directions to “ NICHOLAS PAHL ” Practice Location

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